Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Autumn Victoria Wallace

Individual provider Behavior Technician · NPI 1770148587

Autumn Victoria Wallace is a Behavior Technician in Gonzales, Louisiana. Registered with an NPI since 2019.

In the registry since
2019

Practice location Address checks out

1028 E Worthy St
Gonzales, LA 70737-4367
Phone: (504) 399-9851
Fax: (985) 261-0311
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Behavior Technician (primary) Taxonomy 106S00000X

Record details

NPI number1770148587
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedMay 7, 2019
Last updated in NPPESMay 7, 2019

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